Traumatic epidural hematomas of the posterior cranial fossa (original) (raw)
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Traumatic Epidural Hematoms in Posterior Cranial Fossa: a Clinical Study in Tertiary Care Hospital
2018
Objective: To determine clinical presentation and outcome of traumatic epidural hematoma in posterior cranial fossa. Material and Methods: This descriptive case series was conducted in department of Neurosurgery Mardan Medical Complex Mardan from May 2016 to April 2017. All patients presenting with extradural hematoma in posterior fossa of either gender and age were included in the study while patients with recurrent posterior fossa extradural hematoma and hematoma at other side of the brain were excluded. CT scan Brain with bone window was done in all patients. Patients were followed for one month. Outcome was measured on the basis of GCS and GOS. Results: Total 23 patients were included in the study having age range from 8 to 58 years with mean age was34 ± 5.23 years. 16 (69.56%) were males and 7 (30.4%) were female. Road traffic accident was the most common cause of head injury in 11 (47.8%) cases. Headache and vomiting was seen in 16 (69.5%) cases, drowsiness in 8 (33%), occipit...
2016
Objective: To determine the clinical presentation and outcome of traumatic epidural hematoma in posterior fossa. Methodology: This observational study was conducted in Department of Neurosurgery Lady Reading Hospital, Peshawar from 30th November 2009 to 29th November 2014. We collected data for both operated and non-operated cases of traumatic posterior fossa epidural hematoma, of any gender and age. Patients were followed for 6 months and all the data was analyzed by SPSS version 20 and presented in figures. Results: Total 34 patients were included in the study having age range from 5-60 years with mean age of 32.5±16.24 years. Males were 25(73.52%) and females were 9(26.47%). The most common cause was motor vehicle accident found in 15(44%) cases. seventeen (50%) patients were managed conservatively, while 17(50%) were managed by surgery. Good outcome was found in 28(82.35%) and in remaining 6(17.64%) there was poor outcome. Conclusion: The frequency of posterior fossa epidural he...
Traumatic Posterior Fossa Epidural Hematomas (Travmatik Posterior Fossa Epidural Hematomları)
Objective : Epidural haematoma (EDH) most commonly occurs in the supratentorial area, particularly in the temporal region, of the brain. Posterior fossa epidural haematoma (PFEDH) is less frequently observed, accounting for only 1.2% to 12.9% of all EDH cases. Because of the non-specific symptoms and the potential for rapid and fatal deterioration in children, an early computed tomography (CT) scanning is necessary for all suspicious cases. The aim of the present study was to share the experience of 48 cases and review the literature concerning PFEDH. Methods : A retrospective analysis was conducted for 48 paediatric cases diagnosed with PFEDH and admitted to Yuying Children's Hospital of Wenzhou Medical University from January 2010 to August 2015. The clinical features and outcomes were analyzed and compared with previous literature. Results : Seventeen patients were surgically treated in this series and 31 patients received non-operative treatment. The outcomes were good in 46 patients, evaluated using the Glasgow outcome score (GOS), while mild disability was observed in one patient, and only one case showed severe disability. There were no cases of mortality in this series. Posterior fossa epidural haematoma is relatively rare compared with supratentorial epidural haematoma. Early and serial CT scans should be performed for all suspicious cases. The criteria for the surgical treatment of paediatric patients with PFEDH were concluded. The overall prognosis was excellent in paediatric patients.
Posterior fossa epidural hematomas in children: clinical experience with 40 cases
Journal of Neurosurgery: Pediatrics, 2012
Object Traumatic posterior fossa epidural hematoma (PFEDH) is rare, but among children it may have a slightly higher incidence. With the widespread use of CT scanning, the diagnosis of PFEDH can be established more accurately, leading to an increased incidence of the lesion and possibly to a better patient prognosis. This study presents 40 pediatric cases with PFEDH. Methods The authors assessed the type of trauma, clinical findings on admission, Glasgow Coma Scale scores, CT findings (thickness of the hematoma, bone fracture, compression of the fourth ventricle, and ventricle enlargement), type of treatment, clinical course, and prognosis. Early postoperative CT scans (within the first 6 hours) were obtained and reviewed in all surgical cases. Results Twenty-nine patients underwent surgery and 11 patients received conservative therapy and close follow-up. All patients fared well, and there was no surgical mortality or morbidity. Conclusions Based on the data in this large series, t...
Extradural hematomas of the posterior cranial fossa
Surgical Neurology, 1989
A series of 32 patients with posterior fossa epidural hematoma treated after the introduction of computed tomography scanning between 1975 and March 1988 is presented. Sixteen patients harbored "pure" epidural hematomas, whereas 16 had other infratentorial or supratentorial traumatic lesions. Glasgow Coma Scale on admission was 7 or less in 10 patients, 8-12 in 11, and 13-14 in 11. Only six patients had a lucid interval. Thirty patients were treated surgically; two patients with small hematomas were treated conservatively. Overall mortality was 15.6%, with 0% for "pure" and 31.2% for "complicated" posterior fossa epidural hematomas. The value of routine computed tomography scanning is emphasized in cases with occipital skull fracture or when such fracture is found in patients undergoing emergency evacuation of supratentorial hematomas. The pertinent literature is addressed with special regard to the delayed occurrence, associated lesions, and mortality of posterior fossa epidural hematomas and to the role of computed tomography scanning.
Erciyes Medical Journal, 2017
An epidural hematoma (EDH) following posterior fossa surgery is extremely rarely reported. We report the case of a 49-year-old woman diagnosed with cerebellar lesions and hydrocephalus. The patient underwent left paramedian suboccipital cra-niotomy, and total resection of the lesion was performed. After the surgery, the patient was transferred to the intensive care unit with a Glasgow coma score of 15. Because the patient was neurologically stable, computed tomography (CT) was performed on the first postoperative day. A right, frontal, large EDH was seen on the CT image without any complaint and neurological deterioration. EDH evacuation was performed by right frontal craniotomy, and the patient was discharged with full recovery. This case reinforces the importance of a close follow-up and the early imaging of posterior fossa tumors, particularly with hydrocephalus, for not overlooking this rare, but serious, complication, even if a patient is clinically silent.
Epidural Hematoma: A Prospective Analysis of Morbidity and Mortality in 173 Patients
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2015
Objectives A few recent studies have focused on epidural hematomas (EDHs) that are routine in emergency rooms. The study was to evaluate the latest situation of affected patients by encephalic trauma associated with EDH in our service. Methods Prospective study between September 1, 2003 and May 30, 2009. Data were computed regarding age, sex, trauma mechanism, qualification by Glasgow coma scale admission, presence of anisocoria, and evaluation by the recovery of Glasgow scale high, with all patients by computed tomography (CT) scan. Results Among the 173 analyzed patients, mortality reached 20 patients (11.5%). Mortality was higher in the subgroup of 76 patients (44%) admitted with Glasgow coma scale (GCS 8) with 17 deceased, corresponding to 85% of total deaths. Prevalence of male subjects (140 cases, 81%) with bruises located in the temporal, frontal and parietal regions; 147 (85%) patients underwent neurosurgical treatment by craniotomy. The worst prognosis was in patients with hematomas of higher-volume (50 mL), midline structures deviations greater than 1.5 mm and basal cisterns CSF closed. Conclusion The authors emphasize the correct indication of neurosurgery and the postoperative intensive care unit (ICU) as key factors for success in the treatment of patients with EDHs.
Traumatic Posterior Fossa Hematoma, A Rare Entity: Study of 21 Cases
Journal of Neurosciences in Rural Practice
Background Traumatic posterior fossa hematoma is a rare entity. Traumatic posterior fossa hematomas are associated with considerable morbidity and mortality and their surgical management remained controversial. Methods From August 2011 to August 2017, approximately 5,100 patients with head injury were managed. Authors reviewed clinical and radiological findings, management criteria, and outcome of posterior fossa hematoma in 21 patients. Results Out of 21 cases, 13 survived with our management. The Glasgow Coma Scale (GCS) on admission was higher in favorable group than in poor outcome group. Factors associated with Glasgow Outcome Scale in two groups were status of fourth ventricle, basal cisterns, subarachnoid hemorrhage (SAH), hematoma volume, and their location (hemispheric or midline). Similarly, associated supratentorial lesions, age, gender, lesions in other parts of body, and timing from injury to reporting to hospital were taken into consideration. Conclusion The factors co...
Surgical Acute Epidural Hematoma in Temporal Perioral Region of Brain: Case Report
International Journal of Head and Neck Surgery
Case RepoRt the admission Glasgow Coma Scale (GCS) appear to be the most important determinants of outcome. 11 There are numerous factors that affect the outcome, including age, the time since the injury, whether the patient is in a coma IntroductIon Traumatic brain injury (TBI) threatens the life of its victims. It has been estimated that TBI caused 2.4 million hospitalizations, emergency room visits, or deaths in 2009, according to the Centers for Disease Control and Prevention. The treatment for acute epidural hematoma (EDH) is to perform immediate surgery, which is considered the standard of care for any significant EDH. The incidence of acute EDH (AEDH) is approximately 1-3% among patients with head injuries, but it increases to 5-15% among patients with severe head injuries. 1 Diagnostic imaging with computed tomography (CT) is still the most reliable method to detect this sometimes fatal disorder. 2-4 A patient's age, hematoma size, location, neurological condition, and course should be taken into consideration when deciding whether or not to treat them with EDH. 5-7 Treatment and early detection reduce mortality and improve outcomes. The mortality rate before the CT scan was 20-55%, but now it is 12-20%. 8 Surgical intervention within the "golden hours" is the conventional prescription for symptomatic patients. 9,10 Many independent factors influence the fate of individuals with acute traumatic EDH. The existence of concomitant cerebral lesions and